Ep 73: Why We Need Better Preparation for the Postpartum Period with Dr. Christine Sterling OB-GYN

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I am so excited to have a fellow OB-GYN on the podcast today, especially one who shares my approach to helping mamas and new parents. 

Dr. Christine Sterling is an OB-GYN who teaches parents about the postpartum period through online courses and social media. After experiencing her own postpartum struggles after the birth of her first baby, she realized that we need to do so much more to prepare parents for the unique challenges that arise after baby arrives.

Christine and I talk about how she got into this work and why she is so passionate about what happens after birth. We discuss the need to give yourself grace as a new parent, why our children don't need us to be perfect, and why we should normalize the strain a new baby can often put on our intimate relationships. 

Christine also shares her top tips for preparing for the postpartum period and why you should start thinking about this at the beginning of your pregnancy, not the end. We also chat about mental health and why you need to be your own strongest advocate, and at the end of our conversation she shares one of the best tips for new parents I have ever heard. I think you will get so much out of this conversation - I'd love to hear what you think!

In this Episode, You’ll Learn About:

  • Why Christine decided to make it her mission to prepare parents for the postpartum period
  • Why we should start preparing for postpartum at the beginning of pregnancy
  • How our healthcare system under-prepares parents for the transition into parenthood
  • Why we need to be more open about the fact that having a baby often puts a strain on a relationship, especially in the short-term
  • How to get the most out of your 6-week postpartum visit to your care provider
  • Why you absolutely must advocate for yourself if you think you are suffering with postpartum depression or anxiety
  • What to ask your provider about intercourse, incontinence, and other common postpartum issues that should be treated, not swept under the rug

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Speaker 1: This is a great episode about the postpartum period with fellow OB GYN, Dr. Christine Sterling.

Speaker 2: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a practicing board certified OB GYN who's had the privilege of helping hundreds of moms bring their babies into this world. I'm here to help you be knowledgeable, prepared, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only, and is not a substitute for medical advice. Check out the full disclaimer at www.ncrcoaching.com/disclaimer. Now let's get to it.

Speaker 1: Hello there. Welcome to another episode of the podcast. This is episode number 73, and I am so glad that you are here with me today. On today's episode, I am so excited to have a fellow OB GYN on, Dr. Christine Sterling. And we are talking about the postpartum period. After becoming a mother herself, Dr. Sterling discovered firsthand how little support women receive as they move through the phases of motherhood, especially in the postpartum period. So she has since declared her mission, and she's dedicated her career to filling those gaps in education and support. Dr. Sterling calls herself an expert ally, and the fellow mama BFF women have been waiting for. We have a great discussion, including how she got interested in especially serving moms in the postpartum period, why she made the difficult decision to step away from clinical medicine altogether, some things women can do while they're pregnant in order to get off to a great start, postpartum things women can ask to make the best of the postpartum period and much, much more.

: I always love when I see fellow OB GYN who have a similar approach and philosophy to caring for women that I do, that is one that places women at the center of their experience, really focuses on treating women with compassion and respect and empowering them with information. So I know that you are really going to enjoy this episode. Now, of course, preparing for postpartum is very important, but so is preparing for birth. And I have got the class just to help you. The Birth Preparation Course is my online childbirth education class that ensures you are knowledgeable, prepared, confident, and empowered to have a beautiful birth. With my beautiful birth prep process, you learn how to get in the right mindset for your birth, all the details of labor and birth, how to get prepared for that unpredictability of birth, so you aren't surprised when some of those possibilities pop up if they do pop up.

: You can check out all the details of the course at www.ncrcoaching.com/enroll. I've had so many women tell me that this course is just what they needed right now when so many in-person childbirth education classes have been canceled because of COVID. So do check the class out it's at www.ncrcoaching/enroll. I would love to see you there.

: And before we get into the episode, let me do a quick listen to shout out. This is from EmilieKJ. And the title of the review says "informative and encouraging". The review says, "I'm so enjoying this podcast with my second pregnancy, I love the mix of birth stories, professional interviews, and evidence-based topics. It's also so nice to hear birth and pregnancy related information from a board certified practicing OB GYN". Thank you so much for taking the time to leave that lovely review. I so appreciate it and is so warms my heart that you find the podcast helpful during your second pregnancy.

: All right. So you mentioned you'd like to hear information from a board certified OB. Well, let's go ahead and get into the episode from another board certified OB GYN, Dr. Christine Sterling.

Speaker 1: Nicole: Thank you, Christine, for agreeing to come onto the podcast. I am so excited to have a fellow OB GYN on the podcast and someone who has similar values and goals for the way that women should be cared for during pregnancy and birth. So super excited to have you here.

Speaker 3: Christine: Oh, and I am so happy and honored to be here. Thank you.

Speaker 1: Nicole: Yeah. So why don't you start off by telling us a little bit about yourself and your work and your family?

Speaker 3: Christine: Yeah. So I'm Dr. Christine Sterling. I'm a board certified OB GYN. I have a three year old daughter and I have a three month old son. I am married to another physician and I primarily work now in educating moms and expecting families online through social media and through online courses.

Speaker 1: Nicole: Awesome. Love it. And y'all, we'll talk about how to follow her at the end and her Instagram is so lovely and she does these cute stories with their daughters, so absolutely you have to follow her and we'll talk about all those things. Yeah, for sure. Yeah. So you mentioned that you focus primarily on online education, and I know just from looking through your background and, you know, internet stalking that you don't do clinical medicine anymore. So I'm curious what led you to that decision?

Speaker 3: Christine: Yes. So I stopped clinical medicine in September, 2019. And that decision was something that was not easy to make. I haven't decided that I'm never going back, but essentially, you know, my story starts after the birth of my daughter in 2017. And, you know, I really, really tried to be prepared. I am, you know, I read so many books I was looking at, I was thinking, you know, I really want to be a great mom. And because I'm, you know, I'm a little bit of a nerd. I was like, let's, I'm going to read all these books. I'm going to do all these things to educate myself because I want to be a good mother. And I hit the postpartum period. And it was really, really challenging. We had some breastfeeding difficulties and it was, I coping with kind of the physical recovery and the emotional aspect of that physical recovery was really difficult for me.

Speaker 3: Christine: And I just kinda remember just being in it, you know, in the thick of postpartum tears streaming down my face at 3:00 AM thinking if I, with all of my advantages, all of my knowledge, you know, all of the physical things that were going on, they were hard, but I knew that everything that was happening to me was not abnormal. And it was still so hard with all of my advantages. If I'm having a hard time, what is the parent who does not have my experience and my knowledge and my resources, how can I expect them to be okay? And it really tore me apart. And so when I went back to work, you know, I went back to work full time initially, and that was 60 hours a week doing, you know, clinic days and 24 hour shifts in the hospital. And I felt this moral obligation to prepare parents for postpartum.

Speaker 3: Christine: And I worked in a big group setting. So, you know, 10 doctors, nurse practitioners, that kind of thing. And so when I would see an expecting a parent or parents, I would know that there was the potential that I wasn't going to see them again. And I felt this obligation to just fire some warning shots and give some tangible tools about what to expect afterwards. And, as I'm sure you know, the appointments in pregnancy are oftentimes only 10 minutes, maybe, and I was seeing 25 to 30 people a day. And I started if I was going to have that conversation with everybody and have it on the level that I wanted to, I was never going to leave that office. And so I had to start making these calculations about who I was going to have the conversation with.

Speaker 3: Christine: So I focused primarily on first time parents, because I knew that second time, third time parents already knew that it was going to be hard. And so I didn't have to fire that warning shot, but I also know that, you know, that's not necessarily the case, right? You can have a harder time your second or third time. In fact, you're more likely to experience postpartum depression, your second or third time than you are your first, which is shocking to many, but that's what the data tells us. So I found myself making those kinds of calculations in order to get through my day and be able to go home at a reasonable time to see my child and to spend time with my family. And it was tearing me apart. It was tearing at my very soul to be encountering people. And I just felt that weight of, I'm not saying something that I really want to say, and that's always been my favorite part of being a physician is the educational component, that connection with other people, taking their fears and their worries and reassuring them and educating them about their health.

Speaker 3: Christine: I am at, you know, before I'm a physician, I'm a teacher and I'm a big sister. I have three younger siblings. So that is really the core of who I am and my job was tearing that apart. So I happened to, at that time, make some mom friends in my area through an organization called the Postpartum Health Alliance. And they were influencers on social media, nothing to do with, you know, what my passion was. They were, you know, photography influencers or whatever. And I thought, wow, you know, I could connect to moms on that platform, or parents on that platform and share that message. And so I started doing that and, um, it became clear to me that was in order to really share that message and connect with parents on that deeper level that doing it on an online space would actually make it feasible for me because it wasn't feasible in those 10 minute appointments.

Speaker 1: Nicole: Absolutely. Yeah. And that's, that's a hard decision to come to because we put a lot of time and effort into being a physician.

Speaker 3: Christine: Yeah. I still grapple with that, but I also really, really love the relationships that I've been able to build online that are not constrained in the same way. So it's been nice. Yeah.

: Nicole: And it's hard. It's just really hard. I mean, you mentioned some of the things, you know, obviously I do a lot of education on my platform as well, and that was one of the things, I was always behind in the office, always. And like getting caught up with notes and sometimes I'd be double booked. All of those things just was part of why I don't like, I will never go back in the office. I'm a hospitalist now, but I totally totally get it. Well, I know so many folks are glad you made that decision because you provide some amazing information. And I think does that kind of play into, it sounds like you specifically got interested in the postpartum period, because of your own experience. Is that fair to say?

: Christine: Yeah, no, it's definitely, it was my own experience. And it was once I started using social media and specifically Instagram to talk about these things, I was really flooded with people who were, who, you know, you get to the point where you can kind of, you can predict what people say because they say, nobody told me and I had no idea. And I thought that I was the only one. And so I just, basically what I do is I hear from what people are struggling with. And then I use my expertise if I have it, or if I don't have it, I ask other people to help answer these questions, and these concerns that new parents have. And I really believe that, you know, all of pregnancy, we can be preparing for this, this transition, it's such a huge transition.

Speaker 3: Christine: And that happens in a moment. You know, we go from being a parent to an inside baby, to an outside baby in this moment. And it just, life just arrives full force in moment one. And it's really difficult to do the education once you're already in the postpartum period, because that period there's so much sleep deprivation. It's so overwhelming. And so I like to start it throughout pregnancy and then continue, you know, so that people can be prepared and then continue with, you know, tangible tips and tools for postpartum, for the people who are in the thick.

Speaker 1: Nicole: Yeah. I love it. I love it. And you may get into this when we talk about some of the tips, but how soon did you realize that, wait a minute, as an OB GYN, we do a really terrible job of preparing women for the postpartum period. Like what they get as part of prenatal care is almost nothing. And then the, how, like the six week postpartum check is completely inadequate.

: Christine: You know, it has been one of the most difficult things that I've ever had to grapple with to realize, you know, fortunately I wasn't in practice too long before I had my daughter. I started in private practice in September, 2016. And I had her May, 2017. And in the residency I worked with, we had a lot of midwives who did most of the postpartum work, and we only worked in the very high risk pregnancies. And so certainly I felt very guilty about the fact that I hadn't warned any, I mean, I really didn't know any of those women about what they were going to experience, but we were managing their very complex pregnancies, so well, and I believed our medical care was well, that, that part didn't make me feel as bad because we had such bigger fish to fry, with those patients.

Speaker 3: Christine: And I, our midwives who are so incredible that I feel like, okay, I think that they were, I think that they were well taken care of postpartum. I hope, even though I wasn't, we didn't actually spend much time in the postpartum space at all in residency, but I, when I was going through it, I just, you know, I have to be honest, like when I would see a postpartum visit on my schedule before I had my daughter, I was like, Oh, this will be easy. And I can't imagine, you know, I just worry. I don't remember what, how I really used to do it, but I didn't give it the attention it needed. And that's something that I will live with. And so everything I do now is to, is to definitely try to make up for that.

Speaker 3: Christine: But it's terrible. And you know, to me, it's the ultimate symbol of the patriarchy that when a woman or a person is pregnant, they are considered precious and we care for them so dearly, you know, we see them so often and then they have their baby and it's almost like we act like they're less at risk, but they're not. The data tells us that, you know, up to 60% of mortality, you know, maternal mortality is occurring in the postpartum period. You are still very much at risk in the postpartum period. But really, so the only thing that I can think is it's because there's not a baby in there that we need to protect, that we don't, that we are not offering more comprehensive, postpartum care, and that is not okay. And so to me, it's a moral issue.

Speaker 3: Christine: We need to show up better. And so I had to make a decision of how I was going to fight that and how I was going to make a difference in the world. And I chose to go directly to the people. I had considered going back to academics and doing it that way. And I think that that may be something that I explore in the future so that I can do it both angles, you know, teaching the medical students, teaching the residents, acting, research, that stuff that's really important too. But at the end of the day, when I was thinking about what I'm, where am I going to take my career? I thought there is, I get emotional every time I think about this, there is a mom right now, or, you know, a person who is giving birth, who doesn't know this, and who's going to suffer tomorrow. And I have to show up for her. I can't just wait for, oh, I'm going to teach the medical students. And eventually they're going to trickle through, but they're going to be part of the same broken system. And they're going to have the same 10 minute visits that I did. So I really decided I have to go to the source because there's people who need support and need help now.

Speaker 1: Nicole: I love it. And I mean, you, we went through similar struggles in a way. I mean, I was in academics, left academics. It's, it's hard. You want to do as much as you can, but ultimately you realize that people need help right now. And because of our society and technology and all of those things, you're able to provide really great information to a lot of women. So I know a lot of women appreciate you making that tough choice. So let's get into some practical advice for folks. One of the things you just talked about, and one of the things that I think we certainly do not talk about enough is things that women, women should start preparing for the postpartum period during pregnancy. So what are some things two or three things that you think are the most important things that will help women get off to a great start postpartum?

Speaker 3: Christine: I mean, you can, you can start at the very, very beginning. So for example, first trimester, I have very difficult first trimesters, and there is something that happens to a lot of pregnant people when they are feeling the fatigue, the nausea, the just the, the, the ickiness of that first trimester. If they do that, there is, you know, a lot of people experience productivity, guilt, both as an employee, as a partner, as a family member, as a friend, they will experience that guilt that they aren't able to do more. And I think that oftentimes, you know, as physicians, as OB providers, we can contribute to that because we can say, when they say, Oh, I'm really tired and I'm nauseous. And we say, Oh, that's normal. And when we say normal, I think we diminish it for people.

Speaker 3: Christine: It is common. It is typical. It is usual. It doesn't mean that there's anything wrong, but it certainly doesn't feel normal when you're experiencing it. But when we brush it off as normal and they can't, they are not able to do anything other than get out of bed and, you know, do the very least, maybe they can go to work, you know, and they are feeling that guilt that why are other people able to do that? And so what I, what I talk about in that instances, that's the perfect preparation for motherhood. Really, it's a precursor of, you know, the infamous, like mom guilt, where we feel like we need, we're comparing ourselves to others. And we feel like we should, we should, we should be able to do this. And so really teaching ourselves to get rid of the shoulds and to really give ourselves grace and acceptance for what we are able to do and understand that our best is good enough.

Speaker 3: Christine: And the idea of the good enough mother, we do not need to be perfect. In fact, the perfect mother is not good for our children. We need our children to see us not be perfect and make mistakes and make repairs. And so really you can, every struggle that you experience in pregnancy, if we help women and parents enlighten to the fact that, you know, if we can attack these challenges with tangible tools and understanding of what it means to thrive in parenthood, we can transform those challenges into the foundation of exceptional mother and parenthood, that we can see all of the challenges and say, you know what? That is not a boulder in my path. That is a stepping stone to a better version of me. That's going to be more equipped to handle all of the challenges of postpartum. So there's so many examples of that throughout pregnancy.

Speaker 1: Nicole: So just realizing that being able to start giving yourself some grace for not being quote unquote perfect, and realizing that perfect is actually a myth and not something that you need to aspire to.

Speaker 3: Christine: Yeah. And, you know, and things like the uncertainty, you know, there's so much uncertainty in pregnancy and what do we do in this day and age when we're uncertain, we Google, we Google, we Google, you know, and we just, and we ask around and we're searching for the answer. And to that, I will say, you know, Google is not our friend in pregnancy. I have asked so many people, have you ever been reassured by Google? And I have yet to hear anybody who said, oh yeah, I Googled. And I just felt so much better after that. Right? You know? And so well that, you know, number one is, you know, stepping away from Google and number two is getting comfortable with the uncertainty because that's parenthood, right?

: Nicole: Yeah. For sure.

: Christine: It's not always an answer on the internet or anywhere for what our specific child, our specific family needs. And getting comfortable with that uncertainty and saying, you know what, it's not that research and all that stuff is bad, but there's a, there's a limit to it. At some point we have to say, I have to take the next best step. As my daughter who's obsessed with Frozen Two loves to say all day.

Speaker 1: Nicole: So, so giving yourself some grace being comfortable with that uncertainty, um, anything else that you think women should do or focus on or understand while they're pregnant in order to help them postpartum?

: Christine: I think that one of the things that I like to focus on, because I feel like this is something that our friends don't share with us enough, because everybody's afraid that it's just them. If you are in a partnered relationship, having a baby is a stress on that relationship. Most couples will report. And, you know, the studies are done in married couples. All of the ones that I'm aware of are married couples, but I think it can be generalized to anybody who's in a coupled partnership. Most people will report a decline of marriage satisfaction after the birth of a child, but our society, our culture is telling us, oh, when you see your partner with your baby, you're gonna fall so much more in love. And you paint this really beautiful picture of this new family, and we're just snuggling. And, you know, and it certainly can be like that, but it also can be a huge transition for a relationship.

Speaker 3: Christine: And each person, each parent is on their own journey and we're not necessarily doing it in step. You know, my husband experienced postpartum depression. \.

: Nicole: Oh, wow.

: Christine: And yeah, and, you know, nobody even knows that that's a thing. So that's, you know, that's something that is not studied as much as postpartum depression in women, but, you know, male partners experience postpartum depression somewhere around 10, 15, you know, some studies as high as 20% of men who have new babies will experience postpartum depression. So my husband experienced that, that was really challenging for us. We didn't know what it was until it was gone. And we looked back and the person who I do a lot of my work with, in terms of my online courses is I'm a licensed marriage and family therapist. She's a PhD as well. And she that's, one of her specialties is paternal postpartum depression.

Speaker 3: Christine: So, you know, I didn't even as an OB GYN, I did not even know that that was a thing.

: Nicole: Yeah. Yeah. I didn't either.

: Christine: So really understanding that there is that it can be a stress on our relationship and to normalize that to some extent and give people tools to deal with that. So one of my favorite, very tangible tips for expecting couples is that when we are sleep deprived, the area of our brain, it's called the prefrontal cortex that allows us to strategize and to hold multiple goals in our mind at the same time when we are sleep deprived, that area of our brain doesn't work very well. And that is a big problem for communication, especially communication with an intimate partner, because when your partner does something that you don't like most of the time, we don't just blurt it out. We have some thought beforehand, some strategy goes into that because we have two goals in mind or more, or more than two goals in mind.

Speaker 3: Christine: I want to communicate, you know, what I feel or what I think about this situation. But I also care about the harmony of my relationship. So maybe I don't blurt it out in the middle of the night. Maybe I wait until the morning when we're rested and we can have a conversation. That's not going to lead to an argument now, when you're sleep deprived, that area of your brain that does all that strategizing is just not functioning as well. And so there's just less space in between a thought or an emotion and our reaction. And so that makes communication very difficult or less able to control even our tone, the tone that we use to communicate. And so it is this recipe for discord because all of a sudden you're making all these decisions together, right? Like you're co project managers of a human being. And there's a lot of decisions. I mean, I can remember my husband and I fighting over the size of diapers our daughter was going to wear.

Speaker 1: Nicole: And you look back and you're like, why were we arguing about that?

Speaker 3: Christine: He was always wanting to size up. And I was like, but we have all these size two diapers. Can we just, and we would argue about that. So one just knowing that that's common is really helpful. And then two is something I like to call the hug it out method.

: Christine: And that is when either partner's feeling overwhelmed or you're in one of those conversations that just doesn't seem to be going anywhere. Someone says, I need a hug and you do a 20 second embrace. It's a long hug. And for the first five seconds, you're still going to be mad, you know, but then what that does is, is it actually activates our parasympathetic nervous system, which is the rest and digest nervous system. It allows us to lower, you know, lower your blood pressure, lower your heart rate. And when we are, when we are in the opposite, when we are in the sympathetic nervous system, we fight or flight. That really narrows our experience because we're, you know, we're feeling like we're in danger, we're all ramped up. And so we're not more myopic, our perspective is very narrow. And when we turn on that parasympathetic that rest and digest nervous system with that hug, we can kind of relax into our bodies, feel more at rest. And actually our perspective will start to widen as well. So that's my favorite, like tangible tool for those I'm expecting people who are in an, a partnered relationship.

Speaker 1: Nicole: Gotcha. Gotcha. I love it. I love it. Now, one of the other things that I know you talk about is how to maximize the postpartum visit and things that women can do to, or questions to. So what are your top three tips to make the most of that one visit?

: Christine: So the first and foremost, when it comes to postpartum depression and anxiety, and I wish I didn't have to give this tip because I feel like the ownership should really be on us as the OB providers, but not all OB providers are created equal or care about this as much as others.

: Nicole: That's the truth. Yeah.

: Christine: That's just the reality. So I think a lot of parents will show up to that visit and they will want the provider to figure out that they are anxious or depressed. They won't necessarily, and this isn't true of everybody, but there's some people who feel a degree of guilt or shame around postpartum depression or anxiety. And so they want the provider to figure it out. They want them to say, I think that you have postpartum depression or anxiety.

Speaker 3: Christine: And if you have a provider who feels passionately about maybe they've experienced postpartum depression or anxiety, they have friends who have, they get it. You know, there's just some, there's some providers who get it. And some who maybe they, you know, they never had children. They don't realize, or maybe it's just not their area of interest. And so they kind of gloss over it. I, you know, I personally feel like every OB GYN that I know every midwife that I know really cares, but I get enough messages from parents that I know that there's, there's people out there who, who aren't doing the right thing. So what I want to say is, if you think that you are experiencing postpartum depression or anxiety, say that, say, I think I have postpartum depression and do not let someone tell you, Oh, that's just normal mom stuff.

Speaker 3: Christine: If you don't feel that if it's affecting that your quality of life, I just get too many messages from mama's saying my provider just told me, oh, welcome to motherhood. And I can't, there is nothing that makes my blood boil more. And so I think that that's a problem with the provider, but I think as a patient, what you can do is just say, you know, I don't think this is normal mom stuff. I'm really suffering and I need next steps. So really advocating for yourself around what we call PMADs, the postpartum mood and anxiety disorders. There's, you know, there's many others. It's not just depression, anxiety, there's OCD, there's all kinds of stuff. So really being vocal and not allowing your pain to be brushed off. So that's number one, number two, most people by the time, you know, when they go to that six week visit have not had intercourse yet.

Speaker 3: Christine: And so what will happen is, is there will be no conversation about what happens if intercourse is painful, what do I do? What are my next steps? And so I think everyone, if you have had intercourse and it's not painful, whatever, but if you haven't asked, okay, I haven't had intercourse yet. And you know, this is all types of intercourse because intercourse, even if it's non penetrative can be painful, even without penetration in our course can be painful for women they give birth. So, what do I do if it's painful? What are my next steps? And just have some kind of action plan in place. Again, this, I wish that this was the providers who were leading this conversation, but not all do so making sure, you know, okay, do I call you, do you want me to try something first?

Speaker 3: Christine: What are the things that I'm looking for have that conversation? And then the conversation and this knowing, the third thing is pelvic, like pelvic organ prolapse and urinary incontinence. I think too, and you know, the other thing too is rectus diastasis, but I think that the pelvic organ prolapse and the, and the, so the feeling that, you know, after we have babies, the vagina changes and sometimes our pelvic organs come to, I mean, most of the time they do, I have some prolapse. It's not symptomatic, but I have, you know, most of us end up, even if you don't have a vaginal birth, if you have a belly, you can end up with some degree of prolapse. So talking about, because it may not be in that six week period, the person may not be as aware of it because there's so much else going on, but what do I do?

Speaker 3: Christine: If I start experiencing, what are the symptoms of pelvic organ prolapse? When should it start to get better? What should I do? And having a conversation, if you are leaking any urine, that's not, we normalize that too much. And the problem with normalizing urinary incontinence, you know, people will say, Oh, I had a baby. And now I leak when I cough or sneeze and it's normalized. But the problem with that is, what happens to that person when they're 80 years old. Right? So we can't just say, Oh, it's normal to leak when you're a mom, it's, it is common, typical, unusual. It's not necessarily abnormal because it happens all the time, but it doesn't mean we do nothing. So, having that conversation and again, not allowing it, if you are having urine leakage, we don't do nothing. We do something. And, you know, usually we do, you know, kegel exercise and that kind of stuff, but it also depends, you know, I can't give a blanket statement on what we do because there's different types of incontinence. So there's all of that. So I want everybody to have a conversation with their provider about intercourse, about incontinence that they have at pelvic organ prolapse, because that's really important.

Speaker 1: Nicole: Those are all great things. And honestly, thinking back, you have me feeling like, dang, I was not asking women some right questions in the postpartum visit. And some of it like, unfortunately, like you mentioned, some providers don't care. I mean, let's just the sad reality. And then some providers aren't aren't necessarily, you know, we weren't trained on it. We don't, I don't, you know, we don't get a lot of education, we get a ton about pregnancy, but we just don't get a lot about helping women postpartum. So these are all really great questions and that the idea of advocating for yourself in that, that, that moment, that's something that you have to learn how to do during birth. It's something, you know, during your pregnancy substance, you're going to have to learn to do potentially on behalf of your children. So, it's something we all have to get comfortable with.

Speaker 1: Nicole: And, also it's like, you have to remember, I hate, I hate to put it like, kind of blunt, but I always say to folks, you know, at the end of the day, your doctor or the nurse or whatever, they're just going to go home and keep living their lives or doing whatever they're doing. It's your life, your body, and it's worth you standing up for and advocating for yourself. Because the person on the other side is going to continue to just sort of do their own things. So you really just have to get comfortable advocating for yourself.

Speaker 3: Christine: I completely agree. And I think that really our healthcare issues are so much of a system issue. And so you can have a fantastic human being, a fantastic physician who is, you know, doing what I was doing. I'm making calculations about what I can offer and what I can't in order to get through the day. And it doesn't feel good to them either. I mean, I have enough friends who are physicians to know that this is something, a lot of physicians grapple with. Sure. There are the people who literally don't care. I think that I personally think that they make themselves pretty obvious. Like, you clearly don't care. You know, you are not listening. But I think there's even, I think there's good physicians who are stuck in this really terrible system. So it's not necessarily that individual is, it's all their fault.

Speaker 3: Nicole: It is. We have a bad healthcare system.

: Christine: I don't know how else to say it, we really do. And so I think educating ourselves on how we can advocate with, with the medical system is really important and how we can do so. I think it's to lead with always to see the human in the person who's sitting next to you. I want all physicians to do that because when you see your healthcare provider as another, and you, you talk about this so beautifully, you know, when you have, you've talked about if you're a patient and you're in labor and somebody who you haven't met is going to deliver your baby. You talk about telling them about your hopes, your fears, all of that. That is so, I mean, you and I are so simpatico on that feeling like we need to humanize, this is a human connection.

Speaker 3: Christine: And for a therapeutic relationship needs to be a connection between two humans. Not like I am a doctor and I am a patient, like at the end of the day, we're two humans having a connection. And so when we take physicians off the pedestal, I think that it's a good thing, both for us as physicians and for the patients. And we realized this is a human being and I can get more from them. If I connect with them on a human level, then to act like they are against me, because we see a lot of that too. I'm sure you, you see a lot of that.

Speaker 1: Nicole: Yeah. Folks come into the door and they're like fighting already. It's like, yeah, it's not the best way to start.

Speaker 3: Christine: No. And you know what? It's just, we are the end of the day, midwives, nurses, doctors, we are human beings. And so if we are, if you immediately put human being in the defensive, that's what you're going to get. And we are not, as, you know, we will start closing ourselves off if we are being attacked. And I wish I could say that all of us were just these like beautifully enlightened people. And we never said, Oh God, I don't want to go back in that room. She yelled at me. But you know, we are human beings. And so I think understanding the, you know, the psyche, the, the psychology of healthcare providers can be beneficial in getting better results for yourself and for your family.

Speaker 1: Nicole: Yeah. I agree. Definitely always start off from a place of kindness and connection. Now, if that doesn't work, then you can take it to the next level.

: Christine: But, but like, if somebody is doing something to you without your consent, you don't have to be nice about it.

: Nicole: Exactly.

: Christine: You know, you don't, you don't always have to be nice, but starting there and then escalating as need be. Yeah, for sure.

: Nicole: For sure. Yeah. So what other things do you want women to know about the postpartum period as we kind of get towards the end here?

Speaker 3: Christine: So I think that it's, it's really, what's interesting about the postpartum period is I both want to normalize the struggle. Okay. So I want to get rid of this idea that it's just all sunshine and rainbows, because some people can have experiences like that, but the majority of people are not having just a pure sunshine and rainbows at all.

: Nicole: Like, y'all 99% of people don't.

Speaker 3: Christine: Let's just keep it real. No, it's just, that's just the reality. So I both want to normalize that and I want to work to normalize that it's challenging. It is not sunshine and rainbows, but I also think at this on the same, the same breath, I think that of the struggles of motherhood and parenthood have been over normalized so that we, it's not even that it's been over normalized it's that we, especially, as women have been socialized that motherhood equals, like we have to be martyrs, you know? I get so many messages from moms saying, you know, I feel really guilty, but I want to spend time away from my children. And I feel really bad about that. And I'm like, Oh my goodness. Don't, you know. So I want to say that it shouldn't like there is some struggle, but there is a limit to it.

Speaker 3: Christine: And you deserve, even though it's hard, you deserve to still feel fulfilled and happy, even though there's hard moments. And so I believe that I don't want anybody to feel guilt or shame that they're having a hard time, but I also don't want them to just settle for survival mode. And that's, that's why I have created these. That's why I've created my platform. That's why I've created these online courses, both for expecting parents to kind of prepare them and try to prevent some of these big challenges and a smaller course for people who are in the thick of postpartum to get out of survival mode. Because while it is common, typical, unusual, it does not mean that we have to settle for survival mode. We can end, deserve to be happy and fulfilled in parenthood.

Speaker 1: Nicole: I love that. Like, there's, there's definitely this balance between it's not all sunshine and rainbows, like you said, and that's, that's okay. Like it's okay. Sometimes your child is just going to straight up get on your nerves. I mean, and you still love them with every bit of your heart and soul, but, you know, sometimes things are just challenging. I remember one time sitting, and my daughter's now 10, almost 11, and just sitting like, it was like one or two o'clock in the morning and she's just awake. And like, why won't you go to sleep? Like, why are you torturing me? Why are you doing this to me? You know? So you just, everybody has those moments, but I think it's great that you have these resources to help people both understand, like in that moment what's happening, that it's normal, but then how to get past it, get through it and really thrive. Exactly. Yeah, for sure. For sure. So I like to ask everyone, what is your favorite piece of advice that you'd like to give to expectant, uh, could be moms or parents. What's your favorite piece of advice?

Speaker 3: Christine: Okay. So I gave, I think one of my very favorites is the hug it out method, which I already talked about, but not everybody's in a coupled partnership. So my second favorite piece of advice is that breastfeeding is really, for most of us, is challenging in one way or another. And I recommend that expecting parents pick out a formula and purchase a formula before baby comes, even if they are planning on breastfeeding. Because there are so many options and trying to sift through that if you were not expecting to need to supplement or to need to switch to formula feeding. And that is very emotional for many of us, I don't, you know, people who are planning on formula feeding are emotional about it because there's just this deep biological drive to feed our children. And I think our brain is, is kind of over thousands and thousands of years of evolution before formula arrived to us. That survival is breastfeeding, even though that's not the reality these days. So do not wait until you need it to pick a formula and to go buy it, just have it in your house. So you can just eliminate that overwhelm from the whole situation.

Speaker 1: Nicole: Wow. I've never heard that advice. And that is outstanding because it is very overwhelming when you get to that point and trying to figure out what's what, and all of there's just too many. I mean, it's so much. Yes, absolutely. Absolutely. So, well, thank you so much for agreeing to come on to the podcast. This has been such great, useful, helpful information, and you have so much more to offer. So where can people find you? Guys, she has tons of like downloadable things on our website and then Instagram videos.

Speaker 3: Christine: So my website is www.thesterlinglife.com and that's where you can find my courses. You can find, I have a free library of resources, so like cheat sheets, workbooks, that kind of stuff, for pregnancy, postpartum, preconception, all those things. And then I have, that's where I intermittently blog as well. And then, so that's my website. And then also I do a lot on Instagram and my handle on Instagram is @DrSterlingOBGYN.

Speaker 1: Nicole: All right. Well, love it, love it, love it. And tell me the name of your courses one more time. So folks can do it.

Speaker 3: Christine: The course for expecting parents is Prepared Postpartum and the course for people who are in the thick of it is Postpartum Rescue. And that's a shorter course. It's five lessons, they're all 20 minutes or less and all the videos are captioned. So you can watch them while you're feeding or, you know, while baby's napping on you.

Speaker 1: Nicole: That's a really, really good idea. Yeah. So of course guys we'll link to all of those things in the show notes and thank you again for coming on. I, so, so, so appreciate it.

: Christine: Oh, this has been wonderful. Thank you for having me.

Speaker 1: All right. Wasn't that a great episode? I hope you really enjoyed it and found it informative and helpful. Dr. Sterling has a lot of great information to offer. You should definitely follow her on Instagram, where she does videos, posts, also shares lots of cute stuff about her kids. Now, you know, after every episode where I have a guest on, I do something called Nicole's notes where I do my top three or four takeaways from the episode. So here are Nicole's notes from my conversation with Dr. Sterling.

: Number one, she talks about postpartum anxiety. And this is something that I know that I didn't really realize was a problem. I have trouble with anxiety. Sometimes it's not anything crippling or serious, but certainly have issues with anxiety and thinking back, I know that it was heightened during the postpartum period, for sure, especially with my first daughter who was a preemie baby born eight weeks premature had to have surgery after she was born.

Speaker 1: And I just didn't realize at the time that it was a thing, I'm having anxiety. I know we talk a lot about depression, but not so much about anxiety. So definitely be on the lookout for that possibility of postpartum anxiety as well, and bring it to the attention of your care provider. If it's an issue for you. I also talk about this in episode number 50, one of the podcast with Dr. Alyssa Berlin. She is a psychologist who focuses on taking care of women in pregnancy and postpartum. So check that episode out as well. And I'll link that in the show notes.

: Point number two, she mentioned, and it's something that I talk about a lot as well. 60% of maternal mortality actually happens in the postpartum period. So you need to be prepared with information for things to be on the lookout in the postpartum period. Because again, that's where a lot of the issues can come up. So definitely grab my warning signs to look out for in the postpartum period. It's a free downloadable sheet. You can download it, stick it up on your fridge, just to have it nearby. You can get it at www.ncrcoaching.com/warningsigns. We'll link that up in the show notes as well.

: And then the third thing I want to say is that I know it can feel overwhelming. Like all the stuff we're telling you to prepare for, like, you gotta read the pregnancy books, you gotta do childbirth education, you gotta do education to get ready for breastfeeding. Then you gotta do more learning about the postpartum period. And then of course, how to take care of this tiny human being that you're going to be responsible for. And I know it can feel overwhelming to learn all that stuff, but just take it day by day.

Speaker 1: It's actually not as it comes across. I know there are a lot of sources of information, a lot of places that you can look, but just find like two or three good sources of information and stick with that. Of course, you already have a great source with the podcast and I try to provide sources for you as well, but don't feel like you're going to get overwhelmed with all this stuff. All the things. It doesn't have to be like super duper overwhelming. You don't have to read everything, just find some sources that you really find useful and stick with that. And then as far as the classes go, the classes shouldn't necessarily have to take like tons of your time. My class is about eight hours, a breastfeeding class may be one hour or two hours at the most. And then the infant classes, honestly, I think you figure out a lot of stuff about infants, but they don't have to be super long either.

: So I've just, don't want you to feel overwhelmed about all the stuff or feeling like you have to get through all the sources. You can do it. Just kind of break it down, do a little bit here a little bit there, make it fun, make it interesting. Don't make it feel like a chore or something that's overwhelming or crazy to do. All right. So that's it for this episode of the podcast. Be sure to subscribe to the podcast in Spotify, Apple podcasts, wherever you listen to podcasts. And if you feel so inclined, please leave an honest review in Apple podcast, it especially helps other women to find the show, helps the show to grow. Just this past week, I was number four for podcast on the parenting podcast chart.

Speaker 1: And that is of course due entirely to you guys tuning in. So I so, so, so appreciated. And those Apple podcast reviews are big part of that as well. So please do that if you don't mind. And of course, I just love hearing what you think about the show, it's fuel to help keep me going. And it just warms my heart to hear what you guys have to say. So also, if you want to have a place where you can connect after the show, then check out my free Facebook group, All About Pregnancy and Birth, it's a really supportive, encouraging community. I just love seeing the way that women interact in that group. I'm in the group and the community manager for the group is there as well. She's an experienced doula, but really the best part of the group is, is the women. Lots of positive encouragement. There was a recent post about encouraging someone who was going to have an induction. So I just think you'll find that as a great place to be. That's a no judgment zone. So check that out on Facebook, All About Pregnancy and Birth community. And the next week on the podcast, it's going to be a birth story episode. So of course, come on back next week. And until then, I wish you a beautiful pregnancy and birth.

: Thanks so much for listening to this episode of the All About Pregnancy and Birth podcast. Head to my website at www.ncrcoaching.com to get even more great info, including free downloadable resources on how to manage pain and labor and warning signs to look out after birth. You'll also find information on my free online class, on how to make a birth plan, as well as everything you need to know about The Birth Preparation Course. Again, that's www.ncrcoaching.com and I will see you next week.